U.S. patent application number 17/127000 was filed with the patent office on 2021-06-24 for biofeedback system and methods of using same.
The applicant listed for this patent is Case Western Reserve University, The MetroHealth System, United States Government as Represented by the Department of Veterans Affairs. Invention is credited to BRIAN M. BECKER, NATHANIEL MAKOWSKI, MARK NANDOR.
Application Number | 20210186376 17/127000 |
Document ID | / |
Family ID | 1000005303090 |
Filed Date | 2021-06-24 |
United States Patent
Application |
20210186376 |
Kind Code |
A1 |
BECKER; BRIAN M. ; et
al. |
June 24, 2021 |
BIOFEEDBACK SYSTEM AND METHODS OF USING SAME
Abstract
A tactile biofeedback system includes is disclosed herein. The
tactile biofeedback system can comprise an indicator and a sensor
that is configured to be coupled to a user. A computing device can
be in communication with the sensor and the indicator. The
computing device can be configured to: receive a plurality of
inertial measurements from the sensor, determine, based on the
plurality of inertial measurements from the sensor, an occurrence
of an improper movement, and cause the indicator to notify the user
of the improper movement.
Inventors: |
BECKER; BRIAN M.;
(Cincinnati, OH) ; NANDOR; MARK; (Cleveland
Heights, OH) ; MAKOWSKI; NATHANIEL; (Cleveland,
OH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
United States Government as Represented by the Department of
Veterans Affairs
Case Western Reserve University
The MetroHealth System |
Washington
Cleveland
Cleveland |
DC
OH
OH |
US
US
US |
|
|
Family ID: |
1000005303090 |
Appl. No.: |
17/127000 |
Filed: |
December 18, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62949788 |
Dec 18, 2019 |
|
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 5/6828 20130101;
A61B 5/112 20130101; A61B 5/486 20130101; A61B 5/1116 20130101;
A61B 2505/09 20130101; A61B 5/1122 20130101; A61B 5/6831 20130101;
A61B 5/7455 20130101 |
International
Class: |
A61B 5/11 20060101
A61B005/11; A61B 5/00 20060101 A61B005/00 |
Claims
1. A system for a user, the system comprising: a sensor that is
configured to be coupled to the user; an indicator; a computing
device in communication with the sensor and the indicator, wherein
the computing device is configured to: receive a plurality of
inertial measurements from the sensor; determine, based on the
plurality of inertial measurements from the sensor, an occurrence
of an improper movement; and cause the indicator to notify the user
of the improper movement.
2. The system of claim 1, wherein the sensor comprises an inertial
measurement unit (IMU).
3. The system of claim 1, wherein the sensor comprises a three-axis
accelerometer.
4. The system of claim 1, wherein the indicator comprises a motor
that is configured to cause a vibration.
5. The system of claim 1, further comprising a strap that is
configured to secure the sensor to a leg of the user.
6. The system of claim 5, further comprising an enclosure coupled
to the strap, wherein the enclosure houses the sensor, the
indicator, and the computing device.
7. The system of claim 1, wherein the improper movement corresponds
to an outward thigh swing.
8. The system of claim 7, wherein the computing device is
configured to determine the occurrence of the improper movement
based on a metric surpassing a threshold.
9. The system of claim 8, wherein the metric is an abduction
angle.
10. The system of claim 8, wherein the metric is a foot orientation
angle.
11. The system of claim 8, wherein the metric is a trunk lean
angle.
12. The system of claim 8, wherein the metric is a shank
orientation angle.
13. The system of claim 8, wherein the metric is compared to the
threshold during a select portion of a gait.
14. The system of claim 8, wherein the threshold is adjustable.
15. The system of claim 14, wherein the controller is configured to
automatically adjust the threshold based on at least one of: a
passage of a predetermined amount of time; or a detection of an
improvement.
16. The system of claim 15, wherein the improvement comprises one
of: a change in frequency of steps in which the threshold is
exceeded; or a step in which the metric does not exceed the
threshold.
17. The system of claim 16, wherein the computing device is
configured to determine an occurrence of the step in which the
metric does not exceed the threshold and, reduce the threshold in
response to the occurrence.
18. The system of claim 14, wherein the threshold is adjustable
based on user input.
19. A method comprising: coupling a sensor of a system to a leg of
a user, wherein the system comprises: the sensor; an indicator; a
computing device in communication with the sensor and the
indicator, wherein the computing device is configured to: receive a
plurality of inertial measurements from the sensor; determine,
based on the plurality of inertial measurements from the sensor, an
occurrence of an improper movement; and cause the indicator to
notify the user of the improper movement
20. The method of claim 19, wherein user has a thigh, wherein
coupling the sensor to the leg comprises coupling the sensor to the
thigh of the user.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority to and the benefit of U.S.
Provisional Patent Application No. 62/949,788, filed Dec. 18, 2019,
the entirety of which is hereby incorporated by reference
herein.
FIELD
[0002] The disclosed invention relates to biofeedback systems and
methods, and, in particular, to tactile biofeedback systems that
facilitate gait rehabilitation.
BACKGROUND
[0003] Conventionally, when promoting gait rehabilitation, physical
therapists verbally instruct patients to bend their leg, and the
patients need to think about what their leg is doing. While verbal
cuing is effective in a hospital setting, patients do not always
continue to follow these patterns in her home and community (beyond
hospital based rehabilitation settings). If patients are not
focused on proper gait (e.g., bending the knee), they can
unconsciously develop bad habits.
[0004] Many patients with walking deficits from limb-loss, stroke,
multiple sclerosis, or incomplete spinal cord injury use unhealthy
compensatory strategies while they walk. For example, some patients
use circumduction (swinging the leg out to the side) to generate
toe clearance to prevent falls despite being capable of bending her
hip and knee while it swings forward. In the short-term, this
compensatory strategy effectively generates adequate toe clearance.
Long term, this compensatory mechanism puts undue strain on other
joints, causing joint pain and additional injury, which require
additional treatment. Furthermore, the dysfunctional walking
pattern can result in injurious falls.
[0005] There are some devices that assist with toe clearance, but
each of these devices has deficiencies. An ankle foot orthosis is a
plastic or metal brace that bends (dorsiflexes) the ankle to raise
the toe and prevent it from dragging on the floor. Improved
dorsiflexion can reduce the need for circumduction. Peroneal nerve
stimulators use electrical stimulation to activate the muscles that
generate dorsiflexion. The BIONESS L300Go incorporates a cuff that
stimulates the hamstring muscles that can flex the leg. This
approach directly activates the target muscles. Similarly,
exoskeletons have been developed to directly assist with movements
during walking. While these approaches are effective for patients
who cannot generate the desired movement on her own, they are
unlikely to be adopted by patients who can generate the desired
movements without assistance, but need to be cued to remember to
incorporate good habits.
SUMMARY
[0006] Described herein, in various aspects, are biofeedback
systems and methods.
[0007] In one aspect, a system can comprise an indicator and a
sensor that is configured to be coupled to a user. A computing
device can be in communication with the sensor and the indicator.
The computing device can be configured to: receive a plurality of
inertial measurements from the sensor, determine, based on the
plurality of inertial measurements from the sensor, an occurrence
of an improper movement, and cause the indicator to notify the user
of the improper movement.
[0008] In exemplary aspects, the system can include a small,
lightweight device worn on the thigh that measures thigh
orientation while the leg swings forward and cues the patient with
a sound or vibratory response when he or she circumducts the leg,
swinging it out, instead of bending the leg appropriately while
walking. The vibration or sound can cue the patient to flex his or
her hip and knee instead of using compensatory strategies. In use,
the device can reduce the prevalence of joint pain, falls and
secondary injury, thereby improving patients' quality of life and
saving money.
[0009] Also described are methods of using the disclosed
systems.
DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 is an image of an exemplary biofeedback system as
disclosed herein.
[0011] FIG. 2 is a schematic diagram depicting the operation of the
biofeedback system as disclosed herein.
[0012] FIG. 3 is a schematic diagram depicting an exemplary
biofeedback system as disclosed herein.
[0013] FIG. 4 is a schematic diagram depicting an exemplary
computing device in accordance with the present disclosure.
[0014] FIG. 5 is a schematic diagram showing a patient and
illustrating abduction angle relative to a medial plane.
DETAILED DESCRIPTION
[0015] The present invention now will be described more fully
hereinafter with reference to the accompanying drawings, in which
some, but not all embodiments of the invention are shown. Indeed,
this invention may be embodied in many different forms and should
not be construed as limited to the embodiments set forth herein;
rather, these embodiments are provided so that this disclosure will
satisfy applicable legal requirements. Like numbers refer to like
elements throughout. It is to be understood that this invention is
not limited to the particular methodology and protocols described,
as such may vary. It is also to be understood that the terminology
used herein is for the purpose of describing particular embodiments
only, and is not intended to limit the scope of the present
invention.
[0016] Many modifications and other embodiments of the invention
set forth herein will come to mind to one skilled in the art to
which the invention pertains having the benefit of the teachings
presented in the foregoing description and the associated drawings.
Therefore, it is to be understood that the invention is not to be
limited to the specific embodiments disclosed and that
modifications and other embodiments are intended to be included
within the scope of the appended claims. Although specific terms
are employed herein, they are used in a generic and descriptive
sense only and not for purposes of limitation.
[0017] As used herein the singular forms "a", "an", and "the"
include plural referents unless the context clearly dictates
otherwise. For example, use of the term "a sensor" or "a
measurement unit" can refer to one or more of such sensors or
measurement units.
[0018] All technical and scientific terms used herein have the same
meaning as commonly understood to one of ordinary skill in the art
to which this invention belongs unless clearly indicated
otherwise.
[0019] Ranges can be expressed herein as from "about" one
particular value, and/or to "about" another particular value. When
such a range is expressed, another aspect includes from the one
particular value and/or to the other particular value. Similarly,
when values are expressed as approximations, by use of the
antecedent "about," it will be understood that the particular value
forms another aspect. It will be further understood that the
endpoints of each of the ranges are significant both in relation to
the other endpoint, and independently of the other endpoint.
Optionally, in some aspects, when values are approximated by use of
the antecedent "about" or "substantially," it is contemplated that
values within up to 15%, up to 10%, up to 5%, or up to 1% (above or
below) of the particularly stated value or characteristic can be
included within the scope of those aspects.
[0020] As used herein, the terms "optional" or "optionally" mean
that the subsequently described event or circumstance may or may
not occur, and that the description includes instances where said
event or circumstance occurs and instances where it does not.
[0021] The word "or" as used herein means any one member of a
particular list and also includes any combination of members of
that list.
[0022] The following description supplies specific details in order
to provide a thorough understanding. Nevertheless, the skilled
artisan would understand that the apparatus and associated methods
of using the apparatus can be implemented and used without
employing these specific details. Indeed, the apparatus and
associated methods can be placed into practice by modifying the
illustrated apparatus and associated methods and can be used in
conjunction with any other apparatus and techniques conventionally
used in the industry.
[0023] Disclosed herein are devices and systems that can track
movement of legs or other body parts during gait. For example, the
device and systems can be configured to determine when patients
(referred to herein also as "users") make movements with their legs
that add unnecessary wear and tear to the joints and/or make
walking less efficient. In some optional aspects, a system 100 can
comprise a sensor 102 such as, for example, a three-axis
accelerometer (e.g., a three-degree-of-freedom accelerometer) or an
inertial measurement unit (IMU) and a computing device 104 that is
in communication with the sensor 102. The computing device 104 can
receive a plurality of inertial measurements from the sensor 102
and determine, based on the inertial measurements, an occurrence of
an improper movement (e.g., corresponding to a gait irregularity).
It is contemplated that some IMUs (or other circuit board
structures) have one or more sensors as well as integral computing
architecture to process data from the one or more sensors.
Accordingly, in some optional aspects, it is contemplated that the
computing device 104, as further described herein can comprise
computing architecture integral to the IMU (or other circuit board
structure). Optionally, it is contemplated that the computing
device 104 can further comprise one or more additional computing
devices (e.g., a microprocessor) in communication with the IMU (or
other circuit board structure). In further optional aspects, the
computing device 104 can comprise or be embodied as a
microcontroller.
[0024] The computing device 104 can further be in communication
with an indicator 106. The indicator 106 can be, for example, but
not limited to, a vibrational indicator, an audible indicator, or
an electric stimulator. The indicator 106 can receive a signal from
the computing device 104 in response to an improper movement
occurring and, in response, provide an indication to the user. For
example, the indicator 106 can be a vibration indicator comprising
a motor 108, and the motor 108 can activate for a select period in
response to receiving the signal from the computing device. It is
contemplated that the motor can optionally produce a plurality of
different vibrations to communicate different messages (e.g.,
improper movement, low battery, etc.). In further aspects, the
audible indicator can comprise a speaker for producing an audible
indication. The speaker can optionally be in communication with
memory of the computing device, wherein the memory stores a sound
file that can be played by the speaker. Accordingly, a processor of
the computing device can cause the speaker to play the sound file.
In some aspects, the sound can be mechanically generated via an
actuator (optionally, without the need for a corresponding sound
file). For example, the audible indicator can comprise a diaphragm
and a transducer, and the computing device can provide an
electrical signal that actuates the transducer. Optionally, for an
audible indicator, different sounds can optionally correspond to
different messages.
[0025] In some aspects, the system can further comprise a power
source 110 (e.g., one or more batteries) that is configured to
provide power to one or more of the sensor 102, the computing
device 104, or the indicator 106.
[0026] In some aspects, the system can comprise an enclosure 112.
Optionally, it is contemplated that the sensor 102, the computing
device 104, and the indicator 106 can be housed within the
enclosure 112. Accordingly, it is contemplated that the system 100
can be provided as a stand-alone device 120. In various further
aspects, it is contemplated that one or more of the sensor 102, the
computing device 104, or the indicator 106 can be provided as a
separate component. For example, in various embodiments, the
indicator 106 can be physically decoupled from the sensor 102. This
can be advantageous, for example, for embodiments in which the
sensor 102 is configured to couple to the shoe of the user. In such
embodiments, the indicator 106 can optionally be spaced from the
sensor 102 (e.g., coupled to the ankle). In various aspects, the
computing device 104 can be in communication with the sensor 102
and the indicator 106 via wired or wireless communication. In some
aspects, it is contemplated that the power source 110 can comprise
a plurality of batteries that are positioned for providing power to
the respective components.
[0027] In some optional aspects, components of a smartphone or
other such device can embody at least one of the computing device
or the indicator. For example, it is contemplated that the
smartphone can wired or wirelessly receive inertial measurement
data from the sensor 102, and the computing device of the
smartphone can serve as the computing device 104 that determines
the occurrence of an improper movement. In further aspects, it is
contemplated that the smartphone can serve as the indicator 106.
For example, the smartphone can provide the vibrational sensor or
the speaker for providing indications to the user. Accordingly, in
various optional aspects, the smartphone can be in communication
with the sensor 102. In various further aspects, the smartphone can
be in communication with a computing device 104 that is separate
from the smartphone and that causes the indicator 106 (e.g.,
vibrational indicator) of the smartphone to activate.
[0028] In yet further aspects, it is contemplated that a smartphone
can be adapted to serve as the computing device and indicator while
also providing power for the system 100. In these aspects, it is
contemplated that the smartphone can optionally couple to the
sensor in a wired configuration (e.g., through a cable) to
advantageously minimize delay in data transmission times.
[0029] In various further aspects, it is contemplated that the
system 100 can be configured to detect and log each improper
movement. The system can transmit (e.g., over certain intervals,
intermittently, or when queried) the log of the improper movements
to a remote device (e.g., smartphone, tablet, computer). In this
way, the user can receive feedback about her walking pattern over
time.
[0030] In further aspects, it is contemplated that a smartphone,
tablet, computer, or other remote device can be configured to
interface with the system 100 (optionally, wirelessly) to allow a
user or clinician to set thresholds (e.g., acceptable and/or
nonacceptable ranges of movement, numbers of improper movements
within a defined time period, etc.) or change settings.
[0031] It is contemplated that various attachment features can be
used to couple the sensor to a particular body part for measuring
orientation of said body part during gait. For example, optionally,
the system 100 can comprise a strap 114 that is configured to
couple the sensor 102 to the user (such that the sensor is able to
detect movement of body part of the user). For example, the strap
114 can be configured to extend around the leg or thigh of the
user. The strap can comprise hook and loop, buckle, or other
suitable fastener structures for releasably securing the fastener
with a select circumference. The strap can optionally be elastic.
In further aspects, the system 100 can comprise a clip that can be
configured to clip to a shoe, belt, or pant waist. In still further
aspects, other attachment features, such as adhesives, ties,
clamps, harnesses, etc. can be used depending on the application.
Optionally, the enclosure 112 can couple to the strap 114. For
example, the enclosure can define at least one opening that is
configured to receive a portion of the strap 114.
[0032] It is contemplated that the sensor can be coupled to the
user at a known reference orientation. For example, the sensor can
be positioned on a leg of the user in a particular fixed rotational
orientation about the leg (e.g., centered on the front or back of
the thigh) so that direction of movement of the leg can be
determined. In this way, for example, abduction can be
differentiated from front-to-back swinging.
[0033] Optionally, once the sensor is secured to the user, the
sensor can be calibrated so that its initial orientation is known.
For example, the user can stand in a predetermined orientation and
then press a calibration button, and the computing device can store
orientation values from the sensor as reference orientations. In
further aspects, the sensor can be automatically calibrated. For
example, the IMU or computing device can store, in memory,
conventional calibration instructions that, when executed by at
least one processor of the computing device, automatically
determine orientation after movement during a calibration
period.
[0034] In various optional aspects, the sensor 102 (optionally, the
device 120) can be worn around the thigh and can measure when a
patient swings her leg out to the side to generate toe clearance
instead of bending her knee. Such a movement can correspond to an
abduction. As described herein and with reference to FIG. 5,
abduction can refer to the thigh angle .alpha. relative to the
medial plane 200. The system 100 can detect when the leg swings too
far out to the side (excessive abduction) and, in response, can
activate the indicator 106 (optionally, positioned on the back of
the leg) to remind the patient to bend her knee more and not swing
the leg out.
[0035] Referring to FIGS. 2 and 3, the system 100 can use the
sensed data to determine a metric from the plurality of inertial
measurements from the sensor 102, such as, for example, a measure
of thigh orientation. For example, in some aspects, the sensor 102
(e.g., the IMU) can measure accelerations and velocities, and the
computing device 104 can convert the accelerations and velocities
to an orientation value, to thereby determine a measure of thigh
orientation over time. For example, the sensor can comprise a three
accelerometers that are all orthogonal to each other. Each
accelerometer can change an electrical property (e.g., resistance)
depending on the orientation of the accelerometer relative to a
respective axis of measurement. Accordingly, the electrical
property (e.g., resistance) across each accelerometer can be
measured, and the measured resistance can correspond to an angle of
orientation of each accelerometer relative to the respective axis.
An algorithm can determine a common component of acceleration that
corresponds to the acceleration due to gravity the direction
thereof. The respective accelerations (i.e., acceleration relative
to each axis) can be integrated over time in order to determine
corresponding components of velocity. Additional features, such as,
for example, gyroscopes, a compass, etc., can be incorporated to
complement and improve accuracy of acceleration, velocity, and
orientation data. It is contemplated that the sensor 102 can
comprise a conventional, off-the-shelf IMU that is configured to
measure and output orientation data. The computing device 104 can
compare the metric (e.g., abduction angle) to a threshold. For
example, the threshold can be a maximum abduction angle, and the
abduction angle for the given step can be compared to the maximum
abduction angle. Accordingly, in some aspects, the computing device
can compare the thigh abduction component of orientation (or other
metric) to the threshold to determine if the user is abducting more
than she should be. If the metric (e.g., abduction angle) exceeds
the threshold, the computing device can initiate an indication from
the indicator. For example, the motor can be turned on for a set
amount of time to cue the user to flex his or her knee instead of
circumducting. In some optional aspects, the threshold for the
abduction angle can be at least 5 degrees, at least 10 degrees, at
least 15 degrees, at least 20 degrees, at least 25 degrees, or at
least 30 degrees.
[0036] Optionally, the system 100 can determine, based on inertial
measurement data from the sensor 102, a specific portion of a gait
(e.g., between left toe lift and left heel strike), and the metric
can be evaluated (e.g., compared to the threshold) only within the
specific portion of the gait. This evaluation within only the
specific portion of the gait can be valuable to detect, for
example, steppage gait, as further described herein.
[0037] In some optional aspects, an algorithm (e.g., stored on
memory in of the controller), can update the threshold (e.g.,
reduce the maximum leg abduction threshold) so that the patient can
progressively learn to reduce how much she swings her leg out (the
degree of abduction). Over time, the patient can learn to bend her
knee appropriately and reduce bad habits. For example, the
controller can automatically adjust the threshold based on at least
one of a passage of a predetermined amount of time or a detection
of an improvement. The improvement can be, for example, a change in
frequency of steps in which the threshold is exceeded. In further
aspects, the threshold can be updated dynamically based on a peak
metric (e.g., peak abduction angle) measured during a prior step or
a set of prior steps (e.g., over the course of several steps, ten
minutes, an hour, a day, a week, a month, etc.) or based on a step
in which the threshold is not exceeded. In some aspects, the system
100 can record a peak metric (e.g., abduction) for a particular
step. For example, the IMU can detect heel strike, and the heel
strike can be used to determine a transition between an end of a
step and a beginning of a subsequent step. Based on the peak
metric, and as depicted in FIG. 2, the threshold can be reduced
(or, optionally, increased) as needed to adapt to the user's
movements. For example, optionally, if the user does not surpass
the threshold for one or more steps, the threshold can be reduced
(e.g., by a set increment or as a function of a difference between
the peak metric and the threshold). In further aspects, optionally,
if the threshold is surpassed, the threshold can be increased
(e.g., by a set increment or as a function of a difference between
the peak metric and the threshold). A minimum threshold can be set
so that, within a normal physiological range, the device will not
provide an indication (e.g., activate the motor 108 FIG. 3). That
is, the threshold can be limited not to drop below the minimum
threshold. The minimum threshold can optionally correspond to a
normal gait. For example, the minimum threshold can be five degrees
for abduction. In further aspects, the threshold can be set by user
input (e.g., by a physical therapist).
[0038] In use, the disclosed devices and systems can produce more
efficient walking, a reduction in secondary injuries, and
prevention of pain in other joints. More particularly, it is
contemplated that through use of the system, patients can walk
better and develop better walking habits. These improved walking
habits can lead to reduced secondary care resulting from additional
wear and tear on joints that results from moving in undesirable
ways. Additional benefits include reduced joint pain, decreased
usage of prescribed pain killers, reduced falls, reduced secondary
injury, and increased mobility due to more efficient walking
patterns.
[0039] It is further contemplated that the system can log data
(e.g., number of occurrences of an improper movement, frequency of
occurrences of improper movements, time of said occurrences, etc.).
The data can be provided to a physician or therapist for analyzing
progress. In exemplary aspects, the data can be logged in a remote
computing device (e.g., a server). Optionally, in these aspects,
the data can be selectively and/or remotely retrieved using
Cloud-based data retrieval platforms.
[0040] Experimentally, it is contemplated that the performance of
the disclosed devices and systems can be tested using the following
protocols.
[0041] In laboratory testing First, a patient can walk without
intentionally adapting gait pattern to measure hip abduction
without actively attempting to adjust pattern. Then, the patient
can walk while wearing the device and instructing her to bend her
knee when she feel the vibration. Measure whether she flex her knee
and reduces circumduction.
[0042] Home use testing Patients can take the system home and use
it at home. Secondary injuries can be monitored, and walking can be
measured at one month intervals to determine if there is an
adjustment in knee flexion and circumduction both with and without
the system.
Use Cases
[0043] Particular use cases for the disclosed systems and methods
are summarized below. Accordingly, although various embodiments are
directed to use for minimizing abduction, embodiments can be
adapted so that other cases, as further described herein, can be
addressed to minimize improper gait.
[0044] Circumduction A patient swings her leg out to the side in
order to generate toe clearance. The sensor can be worn on the
thigh. In various other optional aspects, the sensor can be worn on
other portions of a leg (e.g., the shank). A sensor can measure
thigh abduction during swing, and values greater than a threshold
be detected, and an indication (e.g., activation of the vibration
motor worn on the back of the leg) can cue increased knee flexion
and reduced hip abduction.
[0045] Vaulting A patient tilts her hips so that pelvic orientation
is much higher than typical. The sensor can be worn on the belt,
waist, or torso of the patient. The sensor can measure pelvic tilt
during swing, and, if the computing device determines that one or
more values exceed than a threshold, the computing device can cause
an indicator to provide an indication (e.g., activation of the
vibration motor worn on the pelvis near the belt) can cue increased
knee flexion and decreased pelvic tilt. Optionally, a minimum
threshold for vaulting can correspond to the pelvis rotating more
than 5 degrees from horizontal. The threshold can optionally be at
least 5 degrees, at least 10 degrees, at least 15 degrees, at least
20 degrees, at least 25 degrees, or at least 30 degrees from
horizontal.
[0046] Steppage gait A patient exaggerates hip and knee flexion in
swing because she does not generate adequate dorsiflexion. The
sensor can be worn on the shoe or foot to measure foot orientation
in swing. If the computing device detects that a value does not
exceed a threshold within a certain portion of the gait cycle (as
can be determined by the computing device), the computing device
can cause the indicator to provide an indication (e.g., a vibration
motor positioned on the front of the ankle can be activated) to cue
proper dorsiflexion. Optionally, the minimum threshold can be
correspond to the foot tilting more than 10 degrees below level or
greater than 10 degrees below level.
[0047] Equinus gait A patient walks with an extended hip, knee, and
ankle. The device can optionally be worn on the shoe or foot. The
sensor can measure foot/ankle orientation in stance; the computing
device can detect one or more values greater than a threshold and,
in response cause the indicator to provide an indication (e.g.,
activate a vibrational motor on the ankle) to cue reduced tip toe
gait. Optionally, a minimum threshold can be around zero degrees or
slightly above zero degrees. The threshold can optionally be from
zero to 60 degrees.
[0048] Trunk lean A patient tilts her trunk forward or to the side
in order to shift center of gravity and maintain balance. The
sensor can be worn on the trunk above the pelvis and can be
configured to measure forward or lateral trunk lean. The computing
device can detect one or more orientation values above a threshold
and, in response, cause the indicator to provide an indication
(e.g., activate a vibrational motor on the opposite side of the
undesired tilt) to cue shifting body weight in the desired
direction. The minimum threshold (corresponding to typical gait)
can be about 5 or about 10 degrees in variation. For side tilt
(lateral trunk lean), the threshold can optionally be in the range
from about 5 degrees-30 degrees or about 10 degrees-30 degrees up
to 30 degrees. For forward tilt (forward trunk lean), the threshold
can range from about 5 degrees-60 degrees.
[0049] Recurvatum A patient hyperextends her knee for stability.
The sensor can be worn on the shank (lower portion of the leg) to
measure shank orientation during swing and stance. The computing
device can detect one or more orientation values above a threshold
and, in response, can cause the indicator to provide an indication
(e.g., a vibrational motor worn on the back of the thigh can
activate) to instruct a user to flex her knee more. Shank
orientation for normal gait can correspond to a range from about 45
degrees to about -60 degrees. Recurvatum can correspond to the
negative angle being smaller than normal gait.
[0050] It is contemplated that each of the thresholds herein can be
tailored by clinicians/therapists or by algorithms that can be
tailored, via internal programming or clinician/therapist input, to
set maximum and/or minimum bounds for the thresholds.
[0051] As disclosed herein, the computing device can determine,
based on feedback from the sensor 102, where the user is in the
gait cycle. The gait cycle can include, for example, heelstrike,
flat foot, midstance, pushoff, acceleration, mids-wing, and/or
deceleration. In further aspects, the gait cycle can include
initial contact, loading response, midstance, terminal stance,
pre-swing, initial swing, mid-swing, and/or terminal swing. In
various aspects, it is contemplated that certain abnormal gait
patterns can incorporate measurements compared to a predetermined
trajectory rather than a simple angle threshold. For example, the
computing device can be programmed to include an ideal trajectory
along the gait cycle. The ideal trajectory can comprise an
orientation for at least one body part (e.g., hips, thigh, shank,
or foot) for at least one portion of the gait cycle. The system 100
can determine the orientation of the at least one body part, and
compare the at least one body part to the ideal trajectory. If the
trajectory deviates from the ideal trajectory by a threshold, the
system can provide an indication. Such feedback can be
advantageously used for gait irregularities such as steppage gait
and recurvatum, in which certain orientations are proper during
portions of the gait cycle and improper during other portions of
the gait cycle.
[0052] All publications and patent applications mentioned in the
specification are indicative of the level of those skilled in the
art to which this invention pertains. All publications and patent
applications are herein incorporated by reference to the same
extent as if each individual publication or patent application was
specifically and individually indicated to be incorporated by
reference.
Computing Device
[0053] FIG. 4 shows an operating environment 1000 including an
exemplary configuration of a computing device 1001 that, in some
embodiments, can be the computing device 104. In further aspects,
the computing device 104 (e.g., the microcontroller of the device
120, FIG. 1) can be a portion of the computing device 1001. That
is, in some optional aspects, various computing devices can
cooperatively be used with the system 100.
[0054] The computing device 1001 may comprise one or more
processors 1003, a system memory 1012, and a bus 1013 that couples
various components of the computing device 1001 including the one
or more processors 1003 to the system memory 1012. In the case of
multiple processors 1003, the computing device 1001 may utilize
parallel computing.
[0055] The bus 1013 may comprise one or more of several possible
types of bus structures, such as a memory bus, memory controller, a
peripheral bus, an accelerated graphics port, and a processor or
local bus using any of a variety of bus architectures.
[0056] The computing device 1001 may operate on and/or comprise a
variety of computer readable media (e.g., non-transitory). Computer
readable media may be any available media that is accessible by the
computing device 1001 and comprises, non-transitory, volatile
and/or non-volatile media, removable and non-removable media. The
system memory 1012 has computer readable media in the form of
volatile memory, such as random access memory (RAM), and/or
non-volatile memory, such as read only memory (ROM). The system
memory 1012 may store data such as sensor data 1007 and/or program
modules such as operating system 1005 and metric determining
software 1006 that are accessible to and/or are operated on by the
one or more processors 1003.
[0057] The computing device 1001 may also comprise other
removable/non-removable, volatile/non-volatile computer storage
media. The mass storage device 1004 may provide non-volatile
storage of computer code, computer readable instructions, data
structures, program modules, and other data for the computing
device 1001. The mass storage device 1004 may be a hard disk, a
removable magnetic disk, a removable optical disk, magnetic
cassettes or other magnetic storage devices, flash memory cards,
CD-ROM, digital versatile disks (DVD) or other optical storage,
random access memories (RAM), read only memories (ROM),
electrically erasable programmable read-only memory (EEPROM), and
the like.
[0058] Any number of program modules may be stored on the mass
storage device 1004. An operating system 1005 and metric
determining software 1006 may be stored on the mass storage device
1004. One or more of the operating system 1005 and metric
determining software 1006 (or some combination thereof) may
comprise program modules and the metric determining software 1006.
Sensor data 1007 may also be stored on the mass storage device
1004. Sensor data 1007 may be stored in any of one or more
databases known in the art. The databases may be centralized or
distributed across multiple locations within the network 1015.
[0059] A user may enter commands and information into the computing
device 1001 using an input device (not shown). Such input devices
comprise, but are not limited to, a keyboard, pointing device
(e.g., a computer mouse, remote control), a microphone, a joystick,
a scanner, tactile input devices such as gloves, and other body
coverings, motion sensor, and the like. These and other input
devices may be connected to the one or more processors 1003 using a
human machine interface 1002 that is coupled to the bus 1013, but
may be connected by other interface and bus structures, such as a
parallel port, game port, an IEEE 1394 Port (also known as a
Firewire port), a serial port, network adapter 1008, and/or a
universal serial bus (USB).
[0060] A display device 1011 may also be connected to the bus 1013
using an interface, such as a display adapter 1009. It is
contemplated that the computing device 1001 may have more than one
display adapter 1009 and the computing device 1001 may have more
than one display device 1011. A display device 1011 may be a
monitor, an LCD (Liquid Crystal Display), light emitting diode
(LED) display, television, smart lens, smart glass, and/or a
projector. In addition to the display device 1011, other output
peripheral devices may comprise components such as speakers (not
shown) and a printer (not shown) which may be connected to the
computing device 1001 using Input/Output Interface 1010. Any step
and/or result of the methods may be output (or caused to be output)
in any form to an output device. Such output may be any form of
visual representation, including, but not limited to, textual,
graphical, animation, audio, tactile, and the like. The display
1011 and computing device 1001 may be part of one device, or
separate devices.
[0061] The computing device 1001 may operate in a networked
environment using logical connections to one or more remote
computing devices 1014a,b,c. A remote computing device 1014a,b,c
may be a personal computer, computing station (e.g., workstation),
portable computer (e.g., laptop, mobile phone, tablet device),
smart device (e.g., smartphone, smart watch, activity tracker,
smart apparel, smart accessory), security and/or monitoring device,
a server, a router, a network computer, a peer device, edge device
or other common network node, and so on. Logical connections
between the computing device 1001 and a remote computing device
1014a,b,c may be made using a network 1015, such as a local area
network (LAN) and/or a general wide area network (WAN). Such
network connections may be through a network adapter 1008. A
network adapter 1008 may be implemented in both wired and wireless
environments. Such networking environments are conventional and
commonplace in dwellings, offices, enterprise-wide computer
networks, intranets, and the Internet. It is contemplated that the
remote computing devices 1014a,b,c can optionally have some or all
of the components disclosed as being part of computing device
1001.
[0062] Application programs and other executable program components
such as the operating system 1005 are shown herein as discrete
blocks, although it is recognized that such programs and components
may reside at various times in different storage components of the
computing device 1001, and are executed by the one or more
processors 1003 of the computing device 1001. An implementation of
data processing software 1006 may be stored on or sent across some
form of computer readable media. Any of the disclosed methods may
be performed by processor-executable instructions embodied on
computer readable media.
Exemplary Aspects
[0063] In view of the described products, systems, and methods and
variations thereof, herein below are described certain more
particularly described aspects of the invention. These particularly
recited aspects should not however be interpreted to have any
limiting effect on any different claims containing different or
more general teachings described herein, or that the "particular"
aspects are somehow limited in some way other than the inherent
meanings of the language literally used therein.
[0064] Aspect 1: A system for a user, the system comprising: a
sensor that is configured to be coupled to the user; an indicator;
a computing device in communication with the sensor and the
indicator, wherein the computing device is configured to: receive a
plurality of inertial measurements from the sensor; determine,
based on the plurality of inertial measurements from the sensor, an
occurrence of an improper movement; and cause the indicator to
notify the user of the improper movement.
[0065] Aspect 2: The system of aspect 1, wherein the sensor
comprises an inertial measurement unit (IMU).
[0066] Aspect 3: The system of aspect 1 or aspect 2, wherein the
sensor comprises a three-axis accelerometer.
[0067] Aspect 4: The system of any one of the preceding aspects,
wherein the indicator comprises a motor that is configured to cause
a vibration.
[0068] Aspect 5: The system of any one of the preceding aspects,
further comprising a strap that is configured to secure the sensor
to a leg of the user.
[0069] Aspect 6: The system of aspect 5, further comprising an
enclosure coupled to the strap, wherein the enclosure houses the
sensor, the indicator, and the computing device.
[0070] Aspect 7: The system of any one of the preceding aspects,
wherein the improper movement corresponds to an outward thigh
swing.
[0071] Aspect 8: The system of aspect 7, wherein the computing
device is configured to determine the occurrence of the improper
movement based on a metric surpassing a threshold.
[0072] Aspect 9: The system of aspect 8, wherein the metric is an
abduction angle.
[0073] Aspect 10: The system of aspect 8, wherein the metric is a
foot orientation angle.
[0074] Aspect 11: The system of aspect 8, wherein the metric is a
trunk lean angle.
[0075] Aspect 12: The system of aspect 8, wherein the metric is a
shank orientation angle.
[0076] Aspect 13: The system of aspect 8, wherein the metric is
compared to the threshold during a select portion of a gait.
[0077] Aspect 14: The system of aspect 8, wherein the threshold is
adjustable.
[0078] Aspect 15: The system of aspect 14, wherein the controller
is configured to automatically adjust the threshold based on at
least one of: a passage of a predetermined amount of time; or a
detection of an improvement.
[0079] Aspect 16: The system of aspect 15, wherein the improvement
comprises one of: a change in frequency of steps in which the
threshold is exceeded; or a step in which the metric does not
exceed the threshold.
[0080] Aspect 17: The system of aspect 16, wherein the computing
device is configured to determine an occurrence of the step in
which the metric does not exceed the threshold and, reduce the
threshold in response to the occurrence.
[0081] Aspect 18: The system of any one of aspects 14-17, wherein
the threshold is adjustable based on user input.
[0082] Aspect 19: A method using the system as in any one of
aspects 1-18, the method comprising: coupling the sensor to a leg
of the user.
[0083] Aspect 20: The method of aspect 20, wherein user has a
thigh, wherein coupling the sensor to the leg comprises coupling
the sensor to the thigh of the user.
[0084] Although the foregoing invention has been described in some
detail by way of illustration and example for purposes of clarity
of understanding, certain changes and modifications may be
practiced within the scope of the appended claims.
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